Algorithm of Oesterling et al for Management of a Patient with a Renal Angiomyolipoma

Description

A renal angiomyolipoma is a benign tumor ("oma") comprised of an admixture of thick-walled blood vessels ("angio"), smooth muscle ("myo"), and adipose tissue ("lipo"). Oesterling et al developed a protocol for the management of a patient with such a tumor. The authors are from the Johns Hopkins University in Baltimore.

Parameters:

(1) size of the tumor in cm

(2) symptoms

(3) duration and/or severity of symptoms

Symptoms:

(1) flank pain and/or tenderness

(2) hematuria

(3) hypertension

(4) fever (> 37.8°C)

(5) nausea and vomiting

(6) anemia and hypotension

(7) abdominal pain

Diameter	Symptoms	Duration and/or Severity	Management
< 4 cm	none	NA	CT or US annually
< 4 cm	present	mild and intermittent	CT or US every 6 months
< 4 cm	present	severe and/or persistent	angiography with embolization and/or conservative surgery
>= 4 cm	none	NA	CT or US every 6 months
>= 4 cm	present	NA	angiography with embolization and/or conservative surgery

where:

• US = ultrasound

• Conservative surgery may be either enucleation or partial nephrectomy.

• A patient with massive hemorrhage may require an emergency intervention.

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Description

Specialty

ICD-10